- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $577.47 / $5,107.20 / $21,363.60
| Facility | | $577.47 | $5,107.20 | $21,363.60 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $4,000.00 / $10,166.34 / $10,166.34
| Facility | 50 | $4,000.00 | $10,166.34 | $10,166.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,000.00 / $7,757.95 / $14,346.13
| Facility | | $4,000.00 | $7,757.95 | $14,346.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,208.42 / $3,208.42 / $4,122.88
| Facility | | $3,208.42 | $3,208.42 | $4,122.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $401.14 / $610.75 / $1,500.00
| Facility | | $401.14 | $610.75 | $1,500.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $833.49 / $1,083.00 / $2,250.00
| Facility | 50 | $833.49 | $1,083.00 | $2,250.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,912.00 / $16,959.00 / $23,485.00
| Facility | | $2,912.00 | $16,959.00 | $23,485.00 |